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USMLE® Step 1 questions

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USMLE® Step 1 style questions USMLE

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A 37-year-old presents to the emergency department due to fever and chest pain for the past nine days. The pain is sharp, midsternal, worsens with lying down, and improves with leaning forward. The patient also had an upper respiratory tract infection one week ago. Temperature is 38.2°C (100.8°F), pulse is 108/min, respirations are 22/min, and blood pressure is 140/74 mmHg. On auscultation there is a friction rub heard at the left lower sternal border. Laboratory evaluation shows elevated ESR and CRP. ECG is significant for normal sinus rhythm with diffuse ST segment elevation of 1 to 2 mm. Which of the following best describes the class of pathogen causing this patient’s symptoms?  

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Coxsackievirus is a single-stranded RNA virus belonging to the enterovirus genus and the picornaviridae family. It primarily affects the gastrointestinal tract and is mainly transmitted via the feco-oral route. Based on its pathogenicity, Coxsackievirus is divided into two groups: A and B. Coxsackievirus group A affects the skin and mucous membranes, causing hand-foot-mouth disease in children, and coxsackievirus group B, affects internal organs, resulting in more severe conditions such as gastroenteritis, pericarditis, myocarditis, and encephalitis.


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